There are of course numerous situations which require emptying the colon of solid fecal material, liquid or gas. Healthy persons could need such a cleansing for any one of a number of reasons including constipation. In addition it would be required in a number of medical situations including preparation for conducting tests, preparation for surgery and routine emptying of the colon for patients such as paralyzed persons or any person who cannot perform this function naturally. Preparation for testing would include essentially emptying of the colon of solids, liquid or gas prior to injecting therein a barium enema for visual observation under an x-ray machine. It is preferable to empty the colon for virtually any type of surgery in which an anesthetic is used, even if the surgery does not involve opening up the thoracic cavity or the abdomen since fecal material or gas in the colon exerts a pressure on the diaphram, hence imposing limitations on the ability of the patient to breath, and this in turn can lead to collapse of the lungs, pneumonia, vomiting and other problems. Disabled persons such as fecally incontinent persons would include those disabled by age as well as those paralyzed below the waist, or disabled for any reason.
Present systems for attempting to cleanse the colon include two basic procedures; first the use of enemas for the lower colon (from the splenic flexure to the anal opening) and second, the use of oral laxatives for clearing out the upper colon (from the splenic flexure to the cecum). The giving of enemas normally includes multiple enemas of less than 1000 cc, normally approximately 500 cc each, which, incidently, are often inadequate, while having the patient lay on his or her (referred to generically hereinafter as "his") left side. In practice the limit may be approximately 500 cc since above this level the enema solution will tend to leak out of the anal opening around the tube and onto the bed. A single enema of this type is almost never sufficient to cleanse out the entire lower colon so that the nurse or aide is normally given directions to continue giving additional enemas using the same volume of liquid, i.e. about 500 cc, usually until the expelled liquid is "clear". At this time the usefulness of the enema procedure is considered terminated and as noted above any additional waste material within the patient's upper colon is removed by having the patient take laxatives orally and waiting the necessary time until such orally taken laxatives pass completely through the patient's stomach and small intestine, supposedly or with the purpose of cleansing the upper colon including the cecum, the ascending colon, the hepatic flexure, and the transverse colon, urging the solid waste material into and hopefully out of the already cleansed lower colon. Or the enemas may be given after the laxatives.
Although the above described use of the enema concept, i.e. essentially for cleaning only the patient's lower colon, has been used since time immemorial, such procedure has certain significant disadvantages. Multiple enemas are physically exhausting to the patient. Moreover, they can cause dehydration of the patient's body with the attendant loss of water and electrolytes, thereby upsetting both the moisture and electrical balance of the patient's body. This of course can have severe repercussions on the operation of vital organs including the heart. Further multiple enemas irritate the anus and internal lining of the colon and this can be very dangerous, especially in the case of aged patients or those with a diseased colon. In addition to the physical disadvantages, because of the odors and mess of enemas there are the psychological disadvantages of humiliation and embarrassment. In addition to the physical and psychological effects on the patient, there are the very considerable monetary disadvantages in this age of skyrocketing hospital costs. The procedure of giving multiple enemas followed or preceded by the giving of oral laxatives to complete cleansing of the colon will require in virtually all cases at least one additional day in the hospital, with its attendant costs.
Hence, there exists a need for a new and improved system and technique for more effectively cleansing the colon.